Call for further trials needed to make promising antiretroviral gel available to women at risk of HIV as quickly as possible

GENEVA, 3 September 2010—Two further clinical trials are planned to confirm a vaginal gel which has shown potential in reducing the risk of HIV. The results of the first trial of the gel, which were announced in July at the XVIII International AIDS Conference in Vienna, must be confirmed before the product can be made available for general use.

The tenofovir-based gel was found to be 39% effective to reduce a woman's risk of becoming infected with HIV during sex in a study completed by the Centre for the AIDS Programme of Research in South Africa (CAPRISA), a UNAIDS Collaborating Centre on HIV prevention research.

The CAPRISA study was conducted in South Africa with women aged 18 to 40 years who used the gel once during the 12 hours before sex and once during the 12 hours after sex.

Experts at a meeting convened last week by UNAIDS and WHO in Johannesburg, South Africa, proposed that further trials should determine whether different populations of women will have the same level of protection as seen in the CAPRISA trial.

One study, which will take place primarily in South Africa, will establish if the CAPRISA results can be repeated in a variety of settings with a population that includes younger women. It will also evaluate whether the gel can be used safely by sexually active 16 and 17 year olds in settings where HIV incidence is high.

The other study, which will be conducted in other African countries, will examine if a different dosing schedule is safe and effective. It will test if a single application of the gel before sex, or failing that immediately after, is equally effective and safe as the original two dose regimen. The single dose schedule would be less expensive and easier for women to use.

In addition, an ongoing trial being conducted by the Microbicides Trial Network, studying the same gel but used daily, will generate additional data on safety and product use.

Research in the communities where the CAPRISA trial was carried out will also examine how to best promote, distribute, and monitor gel use through existing family planning facilities. This would allow former trial participants and others in their communities to have early access to the new gel, but within the context of programmatic research.

While participants agreed on research priorities, concerns were expressed over the limited funding committed thus far to carry forward the next phase of research, which is estimated to cost US$ 100 million. Only US$ 58 million is available.

Nearly 20 years of research have gone into microbicides. If confirmed, the tenofovir gel would empower women by adding significantly to the options they have to protect themselves from HIV without requiring the cooperation of their male partner. About half the people living with HIV in the world are women. In sub-Saharan Africa more women are infected than men. HIV is a major cause of maternal mortality.

“This promising tenofovir gel is a woman-initiated and controlled HIV prevention tool that could now be within reach,” said Dr. Catherine Hankins, Chief Scientific Adviser to UNAIDS. “Funders, advocates, and scientists can work together to close the funding gap rapidly, gather the evidence, and ensure that no time is lost in getting a safe and effective microbicide to women.”

Convened at the invitation of the South African government, the meeting brought together members of government agencies from South Africa and other countries, microbicide research teams and product developers, women’s health and HIV prevention advocates, people living with HIV, clinical and social science researchers, statisticians, civil society representatives, public health experts, ethicists, and representatives from national drug regulatory authorities.

  UNAIDS Executive Director, Mr Michel Sidibe (left) meeting the President of Burkina Faso, H. E. Blaise Compaore at the African Union Summit in Uganda, 27 July 2010.

Kampala, 27 July 2010 — Investing in the health of women and children was the focus of the high-level Summit of the African Union held 25-27 July in Kampala, Uganda. The meeting, attended by more than 35 Heads of State and politicians, highlighted progress and challenges in advancing Millennium Development Goals (MDGs) 4 and 5, which call for reducing child mortality and improving maternal health.

With only 11% of the world’s population, Africa accounts for more than half of all maternal and child deaths. Despite advancements in global health, the African continent has the world’s highest maternal mortality ratio and infant mortality rate. Progress towards MDGs 4 and 5 has been slow at best, hindered in many countries by a lack of financial resources for health and programme management.

“I strongly believe that a new movement is possible to prevent mothers from dying and babies from becoming infected with HIV,” said President Wade of Senegal, who introduced an agenda item on mother-to-child transmission of HIV at the Summit. “Progress in maternal and child health in Africa—indeed progress in the health of our populations in general—are hugely dependent on progress in the AIDS response.”

According to a recent study published in The Lancet, progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. According to the study, there were an estimated 343 000 maternal deaths in 2008. An additional 60 000 lives could be saved each year if women received appropriate HIV diagnosis and treatment, researchers reported.

  UNAIDS Executive Director, Mr Michel Sidibe (left) meeting the President of Namibia H.E. Hifikepunye Pohamba at the African Union Summit in Uganda, 27 July 2010.

UNAIDS Executive Director Michel Sidibé reminded meeting participants of the critical link between the AIDS response and maternal and child health. Globally, AIDS is the leading cause of death among women of reproductive age. In many countries on the African continent, AIDS is the leading cause of death among infants and young children. Each year, nearly 400 000 children in Africa are born with HIV. While in Kampala, Mr Sidibé reiterated his call for the virtual elimination of mother-to-child transmission of HIV as an achievable goal. He noted, however, that achieving an HIV-free generation—together with MDGs 4 and 5—will depend heavily on strengthened health systems.

“Mother-to-child transmission of HIV has been virtually eliminated in the global North. It is unacceptable that so many babies continue to be born with HIV in Africa,” said Mr Sidibé. Countries such as Botswana have already reached universal access targets for the prevention of mother-to-child transmission of HIV. Many other countries are close behind.

Mr Sidibé was joined at the Summit by Prof. Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, who urged African leaders to mobilize more resources for the AIDS response. “The Global Fund has so far invested more that USD 11 billion in Africa helping countries to reduce maternal and child mortality through targeted interventions addressing AIDS, TB and malaria which are still major killers of African women and children. This support should increase further to meet even better the needs of countries,” said Prof. Kazatchkine.

The lives of mothers and their babies can be saved through a combination of HIV testing and counseling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning or the safe use of breast-milk substitute. The recent announcement at the XVIII International AIDS Conference that a vaginal gel containing the antiretroviral drug tenofovir had been successfully tested opens a potential new avenue for HIV prevention among women.

22 July 2010 - Vienna, Austria - It's a story that unfolds every day around the world but is rarely heard. A woman, man or child living with HIV gets exposed to tuberculosis (TB) in a setting where there are no measures to stop the spread of infection. It could be a workplace, a prison, a clinic or even at home. Soon the person is sick - coughing, feverish and weak.

This story is being told and retold this week among the 20 000 participants gathered for the 2010 International AIDS Conference. It's a story that can end well if the person is lucky enough to have access to both antiretroviral and TB treatment. But too often there is a fatal finish. Without proper treatment about nine out of 10 people living with HIV who become ill with active TB will die within two to three months.

The dual epidemic has fanned across Africa, Asia and Eastern Europe and affects women, men and children from every walk of life. One in four deaths among people with HIV is linked to TB - that's about half a million people who die unnecessarily each year.

"Every three minutes a person living with HIV has his or her life cut off prematurely by TB. This is completely unacceptable, because TB is a preventable and curable disease," said Dr Jorge Sampaio, the United Nations Secretary-General's Special Envoy to Stop TB.

Global public health leaders gathered at this conference have committed to an ambitious new agenda to stop these preventable deaths. Dr Sampaio presided today over the signing of a landmark document: a memorandum of understanding between the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Stop TB Partnership. The agreement binds the two organizations together in a common goal: to strive towards halving the number of people living with HIV who die from TB by 2015, compared to 2004 levels. Provision of life-saving antiretroviral treatment for all TB patients living with HIV is another key objective.

“We already have the tools to keep people living with HIV from dying of TB ”, said Mr Michel Sidibé, Executive Director of UNAIDS, ”We must join our TB partners to promote an evidence and human rights based approach to tackling TB and HIV. Together we can virtually eliminate TB related AIDS deaths.”

Stop TB and UNAIDS will press government health programmes to reach all people in need of care for TB/HIV by integrating the services that provide diagnosis and treatment for both conditions; and also seek to increase the resources needed to accomplish this goal. Another overarching objective is to galvanize civil society organizations, communities affected by TB and HIV and the private sector to form strong partnerships aimed at jointly addressing TB/HIV.

In keeping with the focus of this year's AIDS conference, the signers stressed the needs of marginalized groups. "We call on the world's leaders to promote full access to HIV and TB services for women and girls, orphans, displaced persons, migrants, prisoners, men who have sex with men, people who use drugs other vulnerable groups," said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership.

During 2010 and 2011 the leadership of Stop TB and UNAIDS will make at least two joint visits to countries heavily affected by TB/HIV per year and promote their new initiative at least one international event per year.

GENEVA, 21 July 2010 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) launched today a new UNAIDS High Level Commission on HIV Prevention, which includes more than 15 world renowned leaders. Commissioners will use their unique authority and influence to lead a social and political action campaign over the coming year aimed at galvanizing support for effective HIV prevention programmes.

The Commission is co-chaired by Professor Francoise Barré-Sinoussi, Nobel Laureate in Medicine for her role in the discovery of HIV, and Archbishop Emeritus Desmond Tutu, Nobel Peace Price Laureate.

“Today, for every 2 persons starting treatment, 5 new infections occur,” said Professor Barré-Sinoussi. "The growing curb of the epidemics cannot be stopped without a strong and global commitment to combined HIV prevention measures, including treatment."

Archbishop Tutu said, "The only way to be cured of HIV is not to be infected. For the sake of the future, and for the sake of those currently living with HIV, we must take the path to zero new HIV infections."

“We have received amazing leadership support for the UNAIDS High Level Commission on HIV Prevention,” said UNAIDS Executive Director Michel Sidibé. “The greatest successes in the AIDS response have been achieved in countries where the leadership has mobilized and made reducing new HIV infections a top priority. With the backing of these celebrated personalities, we can bring about a prevention revolution and reverse the AIDS epidemic.”

The members of the Commission are:

• Dr Michelle Bachelet, Former President of Chile;
• Mr Jacques Chirac, Former President of France;
• Ms Vuyiseka Dubula, Secretary-General of the Treatment Action Campaign;
• Dr Mohamed ElBaradei, Nobel Peace Prize Laureate; 
• Ms Elena Franchuk, Ukrainian businesswoman and founder of the Elena Franchuk ANTIAIDS Foundation;
• Mr Pau Gasol, Spanish professional basketball star; 
• Mr Nizan Guanaes, leading Brazilian communications entrepreneur, Chairman of Grupo ABC de Comunicação;
• Mr Chris Hughes, Executive Director of Jumo, International, co-founder of Facebook;
• Mr Magic Johnson, Former basketball star and one of the first sports celebrities to declare his HIV-positive status;
• Ms Irene Khan, Human rights activist and former Secretary-General of Amnesty International;
• Mr Robin Li, Entrepreneur and co-founder of China’s most popular independent search engine, Baidu, Inc.;
• Ms Rita Süssmuth, former President of the German Federal Parliament and former Federal Minister for Family Affairs, Women, Youth and Health;
• H.E. Festus Mogae, Former President of Botswana;
• H.E. Jean Ping, Chairman of the African Union;
• Professor Peter Piot, Former Executive Director of UNAIDS and incoming Director of the London School of Hygiene and Tropical Medicine;
• Mr Vladimir Vladimirovich Pozner, celebrated Russian journalist;
• Mr Mechai Viravaidya, Thai politician and activist, famous for popularising condoms in Thailand.

A Scientific Advisory Panel chaired by Ms Laurie Garrett of the Council on Foreign Relations will assist the High Level Commission by using state-of-the-art scientific research to develop a road-map incorporating the best strategies in HIV prevention.

“We will look at what works in HIV prevention, drawing attention to country level successes and elaborating actions needed to overcome current failures and deficiencies," said Ms Garrett.

Thirty years into the AIDS epidemic, the world has made unprecedented progress in the treatment of people living with HIV. But over 7,000 new HIV infections occur every day.  While treatment has grabbed the limelight as a key strategy in the AIDS response, prevention has often been neglected. The Commissioners will take the message of a recommitment to HIV prevention to their circles of influence, swaying public opinion to support the implementation of effective HIV prevention programmes.

VIENNA (20 July, 2010) – Following significant advances in vaccine and microbicide research, including results presented today of 39% efficacy in the CAPRISA 004 microbicide gel trial among women in South Africa, a new report released today warns that flat funding for HIV prevention research may limit researchers’ ability to quickly move promising approaches forward.

The report examines investment in HIV prevention research in 2009 and finds that the onset of a global recession did not immediately impact funding levels for biomedical HIV prevention research.  Total funding remained stable at approximately US$1.165 billion for preventive vaccines, microbicides, pre-exposure prophylaxis (PrEP) and operations research related to male circumcision.

In the face of an economic crisis that has deeply affected the economies and public-sector budgets of HIV prevention research funders, level funding for HIV prevention is cause for cautious optimism. Yet much of the 2009 funding was likely reflective of resources committed when the global economy was far healthier. As current funding commitments come to an end, the concern will be whether funders will be able to renew commitments at existing funding levels. Furthermore, the report authors argue that flat funding of HIV prevention research could have serious consequences for the field as results from critical prevention trials move the research agenda forward. They warn that researchers could have insufficient resources to advance important opportunities to prevent HIV.

Advancing the Science in a Time of Fiscal Constraint: Funding for HIV Prevention Technologies in 2009, the sixth annual report from the HIV Vaccines and Microbicides Resource Tracking Working Group, was released today at the XVIII International AIDS Conference in Vienna, Austria.  It documents investments in biomedical HIV prevention research from public, philanthropic and commercial sectors in 2009. HIV vaccines continued to receive the majority of funding, with a total of US$868 million, which was equal to 2008 funding levels. Investment in microbicides was US$236 million, a decline of 3 percent from 2008 levels. Funding for oral pre-exposure prophylaxis (PrEP) increased by 18 percent over 2008 levels to US$52 million.

The stability in funding is encouraging, given a 10 percent decrease in funding for AIDS vaccine research seen in 2008, but the Working Group identified several areas of concern if funding remains flat, including escalating costs of late-stage clinical research, dependency on a small group of funders and a lack of diversity in funders. In addition, the Working Group stresses that the CAPRISA 004 results, while tremendously exciting, are by no means the definitive answer about antiretroviral-based microbicides and appropriately resourced confirmatory and exploratory research will be needed.

The Working Group has documented an overall trend since 2000 toward increased funding of new funders joining in the effort to support HIV prevention research. Yet in 2009, this funding stability was largely the result of increased or sustained funding by the U.S. National Institutes of Health and the Bill & Melinda Gates Foundation, which together accounted for 79 percent of vaccine funding, 59 percent of microbicide funding and 70 percent of PrEP funding.

“With five new infections, for every two people newly on treatment we cannot give up our quest for new HIV prevention tools” said Michel Sidibé, Executive Director of UNAIDS. “Investments for HIV prevention must be enhanced and sustained.”
 
“As we push for expanded funding and political commitments for HIV prevention research and the overall AIDS response, we must also work to find smart and innovative ways to make the best use of available funding to continue to scale up delivery of existing interventions and to look for new ones,” said Mitchell Warren executive director of AVAC. “HIV prevention researchers, advocates and donors must all commit to working together to ensure that we make the best and smartest use of limited resources, while also ensuring that the most promising interventions continue to move forward.”

Recent and upcoming results from several major studies could radically change the trajectory of HIV prevention research and increase the need for funding. These include the results of the RV144 Thai AIDS vaccine trial, which showed modest protection against HIV and scientifically demonstrated for the first time that an AIDS vaccine was possible, results from an important proof of concept microbicide trial CAPRISA 004, released yesterday at the Vienna AIDS conference, and anticipated results from two PrEP trials in the coming year.

“This is a very exciting time in HIV prevention research,” said Seth Berkley, President and CEO of the International AIDS Vaccine Initiative. “As the prevention research field is primed to exploit scientific advances availability and flexibility of funding will be critically important.  Our ability to move discoveries into and to undertake even the most critical of these large-scale trials is at risk in the current funding environment.”

 “We must work to continuously ensure resources are available to fulfill the promise of new scientific advances that could save millions of lives,” said Dr. Zeda Rosenberg, CEO of the International Partnership for Microbicides.  “Microbicides, PrEP, vaccines and treatment-as-prevention are just beginning to show great promise for HIV prevention in large-scale trials.  As we work together to develop these tools and transform our global health goals into reality, our success depends on having sufficient resources to keep pace with research developments in the field.”

Since 2004, the HIV Vaccines and Microbicides Resource Tracking Working Group has generated estimates of research and development investment that can be compared year to year, from one HIV prevention technology to another, and across funding sources.  This effort supports the 2001 United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS, which called for the development of sustainable and affordable prevention technologies, such as HIV vaccines and microbicides. Information collected in previous years has also been used by the Working Group and others to monitor levels of effort, to analyze the significance of investment trends, and to assess the impact of public policies aimed at accelerating scientific progress.

The Working Group is composed of  AVAC: Global Advocacy for HIV Prevention (AVAC), the International AIDS Vaccine Initiative (IAVI), the International Partnership for Microbicides (IPM), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

More information is available online at www.hivresourcetracking.org.

Calls for 51 remaining countries with such “travel restrictions” to take action towards their removal

VIENNA, 20 July 2010 — UNAIDS Executive Director Michel Sidibé applauded today the leadership displayed by China, Namibia and the United States of America to lift their travel restrictions for people living with HIV, while calling for similar action in all countries that continue to employ such discriminatory measures.

Namibia is the most recent of the three countries to remove HIV-related restrictions on entry, stay and residence.  Its reforms—which took effect on 1 July—also remove such restrictions against people living with other contagious diseases.  "Namibia is very pleased to lift travel restrictions,” said Hon. Richard Kamwi, the Namibian Minister of Health, speaking at a press conference at the International AIDS Conference in Vienna. “With this move we have formally removed this discrimination. There is no way we will make headway without people living with HIV playing a vital role."

Mr Sidibé underlined that restrictions that limit mobility and migration based on HIV-positive status violate human rights. There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives.  “Travel restrictions for people living with HIV serve no purpose other than to fuel stigma and discrimination,” said Mr Sidibé. “I urge all other countries with such restrictions to remove them.”

Last year, President Obama announced that the United States would lift its long-standing HIV-related travel restrictions, overturning a policy that had been in place since 1987. "The lifting of the HIV-specific U.S. entry ban is a sign of a renewed commitment to global health,” said Dr. Howard K. Koh, Assistant Secretary for Health, U.S. Department of Health and Human Services.  "With this announcement, the U.S. looks forward to hosting the 2012 International AIDS Conference in Washington, DC."

Restricting the mobility of people living with HIV is one example of the many forms of laws, policies and practices that undermine the AIDS response.  A new document launched at this week’s Vienna conference by UNAIDS, the Global Network of People Living with HIV (GNP+), the International Harm Reduction Association, the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), and the International Planned Parenthood Federation (IPPF) provides a broad “snapshot” of the legal environment related to HIV. Titled “Making the law work for the HIV response,” the matrix covers over 190 countries, territories and entities, detailing whether or not a country has certain types of protective or punitive laws which either support or block the attainment of universal access to HIV prevention, treatment, care and support. 

“It is incomprehensible that HIV-related entry and residency restrictions still exist in these times,” says Mr Kevin Moody, International Coordinator and CEO of GNP+. “These restrictions are blatant violations of human rights, stimulating stigma and discrimination and actually hurting the response to the HIV epidemic.”

International AIDS Conferences and meetings have had a major influence on the reversal of HIV-specific entry and residence restrictions in recent years.  The International AIDS Society will not sponsor major HIV and AIDS-focused conferences or events in a country with HIV entry restrictions. 

"I'm proud of the role International AIDS Conferences and other international fora continue to play in advancing the removal of these and other laws that are counter to public health and human rights principles," said Dr Julio Montaner, President of the International AIDS Society. "HIV-specific laws and regulations on entry and residence are both overly intrusive and ineffective public health policy." 

After the removal of Namibia's restrictions, UNAIDS counts 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV. These include restrictions that completely ban entry of HIV-positive people for any reason or length of stay; ban short stays, for example for tourism; or prevent longer stays, such as immigration, migrant work, asylum, study, international employment, or consular service.

In July 2008, United Nations Secretary-General Ban Ki-moon reiterated the long-standing United Nations call for the elimination of HIV-related restrictions on entry, stay and residence. UNAIDS is closely monitoring which countries continue to employ them and has designated 2010 as the “year of equal freedom of movement for all.”

VIENNA, 19 July 2010 -  An underground HIV epidemic in Eastern Europe and Central Asia is intensifying at an alarming pace, fueled by drug use, high-risk sexual behavior and high levels of social stigma that discourage people from seeking prevention information and treatment, according to a new report released today by UNICEF.

The report, “Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia,” highlights the issues faced by children living with HIV, adolescents engaged in risky behaviors, pregnant women using drugs, and the more than one million children and young people who live or work on the streets of the region.   

Marginalized young people are exposed on a daily basis to multiple risks, including drug use, commercial sex and other exploitation and abuse, putting them at higher risk of contracting HIV.   The trends are especially troubling, as the region is home to 3.7 million injecting drug users – almost a quarter of the world total.  For many, initiation into drug use begins in adolescence.

Existing health and social welfare services are not tailored to adolescents at greatest risk, who are often exposed to moral judgment, recrimination and even criminal prosecution when they seek treatment and information on HIV. 

“Children and adolescents living on the margins of society need access to health and social welfare services, not a harsh dose of disapproval,” said Anthony Lake, UNICEF’s Executive Director. 

To reach and help young people living with HIV or at risk of HIV infection, medical and civil authorities need to establish non-judgmental, friendly services that address the special needs of marginalized adolescents.

In the Russian Federation, for example, over 100 youth-friendly service facilities have been established, providing reproductive and sexual health services, information, counseling and psychological support.  The Atis health center in Moldova is another initiative that is showing promise and saving lives.

“We cannot break the trajectory of the AIDS epidemic in eastern Europe and Central Asia without empowering and protecting children and adolescents,” said Michel Sidibé,  Executive Director of UNAIDS. “We must not rob them of their childhood.”

“It is our responsibility to ensure that they have access to HIV prevention and treatment services.”

An HIV prevention and treatment center in Tajikistan is breaking down barriers of mistrust to reach adolescent girls selling sex.  As one young client said, “In the beginning, I did not believe that the medical check-up, the treatment and condoms would really be free of charge and anonymous.  I thought it was another trap by the police.  I agreed to go there with an outreach worker for the first time, but now I go there alone and encourage my friends to use the service as well.”

A recent six-country UNDP study conducted in the region showed that many adults living with HIV fear the social stigma attached to seeking treatment more than they fear the disease, thus driving the epidemic further underground.

The stigma associated with HIV is not restricted to adults and adolescents.  Young children living with HIV are routinely denied access to school and kindergartens, and when their status is known, they face rejection and abuse.  Alla, the foster mother of an HIV-positive child, tells how her son was ostracized when someone leaked his HIV status to other families. “His classmates say that he is ‘disgusting’ and refuse to play with him,” she said.

“This report is a call to protect the rights and dignity of all people living with or at risk of exposure to HIV, but especially vulnerable children and young people.  We need to build an environment of trust and care, not one of judgment and exclusion,” said Lake.  “Only by reversing discrimination against people living with HIV, can Eastern Europe and Central Asia begin to reverse the spread of the epidemic.”

Vienna, 19 July 2010 – Today several of the world’s largest institutions that are critical to serving the needs of women and children are pledging their commitment to work jointly with the United Nations Secretary General and others in a new global effort to save the lives of more than 10 million women and children.  Organizations serving women, children and people living with HIV such as UNAIDS, UNFPA,  UNICEF, WHO, the World Bank, the Global Fund to Fight AIDS, TB and Malaria, and the Partnership for Maternal, Newborn and Child Health are  coming together with leaders in the NGO community including Family Care International, World Vision International, International Council of AIDS Service Organizations, Care, Save the Children, the International Planned Parenthood Federation and countless others to unite in the effort to improve maternal and child health and  save the lives of millions of women and children.

The United Nations Secretary-General Ban Ki-moon launched a new effort this year, the Joint Action Plan for Women’s and Children’s Health, that builds on existing initiatives to drive integration and synergies, and identifies new commitments to women’s and children’s health from all sectors of society.  2010 has been called a tipping point, a historic year where the world came together to improve the health of women and children.  However, HIV and AIDS remains a top killer of women and children around the world.

Integrating HIV/AIDS with Women’s and Children’s Health Programmes Critical to Success

“Addressing HIV/AIDS and improving women’s and children’s health are inextricably linked,” said United Nations Secretary-General Ban Ki-moon. “One cannot succeed without the other.”

Half of adults living with HIV are women, and young women between 15 and 24 years of age are at particular risk of sexual and reproductive ill-health due to HIV infection. Globally, the two leading causes of death in women of reproductive age are HIV and complications of pregnancy and childbirth, and a recent analysis indicates that HIV may have increased maternal deaths, especially in sub-Saharan Africa, by almost 20%. More than 2 million children were living with HIV; almost half a million children were infected and more than 250,000 died of AIDS in 2008.

"The AIDS response is already contributing to maternal, new born and child health through strengthening health systems and community responses," said Paul De Lay, UNAIDS Deputy Executive Director, Programmes. "When AIDS is out of isolation, we can achieve wider health outcomes."

“Listening to women we know that they want to go to one place to have their health needs met – for family planning, maternal healthcare and services for HIV/AIDS.  Linking sexual and reproductive health and HIV makes sense. It saves lives, delivers more health for the money – and it works for women,” said Purnima Mane, Deputy Executive Director of UNFPA, the United Nations Population Fund.

AIDS prevention and treatment efforts have paved the way to reach women and children for other critical health needs, and maternal and child health services provide a crucial entry point for HIV prevention, treatment and care.

"The Joint Action Plan for Women’s and Children’s Health represents a fresh opportunity to look at how we can deliver integrated health care services for women and children across the full continuum of care,” said Ann Starrs, President of Family Care International. “Advocates who work on maternal and child health and on HIV/AIDS must work together to increase resources for health, rather than competing for the bigger slice of the pie.”

The Joint Action Plan for Women’s and Children’s Health

The Joint Action Plan is a historic opportunity led by the United Nations Secretary-General Ban Ki-moon to improve the health of women and children, calling on international, national, business and civil society leaders to intensify efforts. The Joint Action Plan focuses on women and children because they are the engines that drive our families and our communities, our economies and our nations. The Plan builds on existing efforts and aims to spur progress through an integrated package of health interventions to ensure women’s and children’s health.

The Joint Action Plan is a historic opportunity to join a growing global movement that will make history.  New financial, service delivery and policy commitments will be announced during the 2010 Millennium Development Goals (MDG) Summit in September.

VIENNA, Austria – Overall support for global AIDS efforts from donor nations flattened in the midst of last year’s global economic crisis, according to a new analysis of 2009 funding levels from the Kaiser Family Foundation (KFF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

In 2009, the Group of Eight nations, European Commission (EC) and other donor governments provided US$7.6 billion for AIDS relief in developing nations, compared with US$7.7 billion disbursed in 2008.

The 2009 totals ended a run of annual double-digit percentage point increases in donor support for international AIDS assistance since at least 2002, when donor governments provided a total of US$1.2 billion.  The results are consistent with preliminary data about overall trends in official developmental assistance during last year’s global recession and economic instability.

 “Donor nations essentially were treading water last year on AIDS relief, but did not cut back overall as they dealt with the economic tsunami that sparked a global recession,” KFF President and CEO Drew Altman said.  “Time will tell whether support will resume its rapid growth once the global recovery takes hold.”

“Reductions in investment on AIDS programs are hurting the AIDS response. At a time when we are seeing results in HIV prevention and treatment, we must scale up, not scale down,” said Michel Sidibé, UNAIDS Executive Director. 

This year’s totals reflect a substantial increase in funding provided by the United States (rising from US$3.95 billion in 2008 to US$4.4 billion in 2009), which helped to offset reductions in support from Canada, France, Germany, Ireland, Italy, and the Netherlands

The United States remains the largest donor nation in the world, accounting for more than half (58%) of 2009 disbursements, followed by United Kingdom (10.2%), Germany (5.2%), the Netherlands (5%), and France (4.4%). Denmark accounted for 2.5%.

The new report provides the latest data available on donor funding based on data provided by governments and collected and analyzed by researchers as part of a collaborative effort between Kaiser and UNAIDS, with research assistance provided by the Stimson Center.  It does not examine donor nation support for other health and development efforts.

Other key findings include:

• UNAIDS estimates that US$23.6 billion was needed to address the epidemic in low- and middle- income countries in 2009.  That suggests a growing gap of US$7.7 billion between available resources and need, according to UNAIDS estimates.
• In 2009, donor governments disbursed US$5.9 billion bilaterally and earmarked funds for HIV through multilateral organizations, as well as an additional US$1.6 billion to combat HIV through the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$123 million to UNITAID.

The full report is available online at the Kaiser Family Foundation’s website at http://www.kff.org/hivaids/7347.cfm or on the UNAIDS’ website http://www.unaids.org/.

UNAIDS concerned that a number of counties in this region are reporting reductions in critical investments in the AIDS response.

VIENNA, 16 July 2010 — Eastern Europe and Central Asia is the only region where HIV incidence clearly remains on the rise. Early indications are that the number of newly diagnosed HIV cases in 2009 has increased since 2008. Russian Federation has reported an 8% increase in reported cases, Georgia a 10% increase and Belarus a 22% increase.

Injecting drug use remains the primary route of transmission in the region. Use of contaminated equipment during injecting drug use was the source of 57% of newly diagnosed cases in eastern Europe in 2007. An estimated 3.7 million people in the region currently inject drugs, of which one in four are believed to be HIV positive.

“It should concern all of us that some countries are closing down HIV prevention services for injecting drug users when they should be scaling up,” said Mr Michel Sidibé, Executive Director of UNAIDS. “Epidemics driven by injecting drug use can grow rapidly when HIV prevention services are not available.”

In the latest round of country progress reports, coverage of HIV prevention programmes for injecting drug use remains low. In the Russian Federation, coverage was 23.8% in 2007, but only 13.6% in 2009 and Georgia went from 17% down to 11.4% in the same time period.

As most injecting drug users are sexually active—often with non-injecting partners—the existence of a major injection-driven epidemic has also fuelled a growth in heterosexual transmission of HIV in the region. Ukraine has the highest level of reported HIV cases in the region. The number of new infections in the country has gone up from 18,963 in 2008 to 19,840 in 2009, and heterosexual transmission has eclipsed injection driven transmission.

The news comes as the global AIDS community gathers in Vienna for the XVIII International AIDS conference. 

“Eastern Europe can not lag behind in the prevention revolution,” added Mr Sidibé. “Evidence shows unequivocally, harm reduction programmes save lives and are a smart investment.”